Individual
MR. CHARLES DUANE WALTHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5353 E YALE AVE, DENVER, CO 80222-6902
(303) 757-1209
Mailing address
6116 W ARIZONA AVE, LAKEWOOD, CO 80232-5709
(720) 938-5907
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13894
CO
Other
Enumeration date
07/15/2016
Last updated
07/15/2016
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